Down but not out

Abstract

A new study in monkeys suggests that treating HIV infection early with antiretroviral therapy reduces the number of latent viruses, but has little impact on viral reactivation when treatment stops.

Keywords: HIV; Monkeys; SIV; antiretroviral therapy; infectious disease; latent reservoir; microbiology; viral latency; virus.

Figure 1.. The timing of antiretroviral therapy influences the size of the latent reservoir.

Without treatment, cells infected with actively replicating virus (productively infected cells; shown in green) create infectious viruses. A minority of infected cells contain viruses that can persist indefinitely as a latent reservoir (latently infected cells; shown in gray), and these viruses can potentially be reactivated at a later date. Treatment administered during the acute phase of infection (that is, within days or weeks of primary infection; yellow curve) results in a smaller latent reservoir than when treatment is initiated early (within six months of infection, light blue) or during chronic infection (more than 6 months since infection, violet). If treatment is stopped (dashed line), the virus reactivates from these reservoirs at similar levels to rekindle active infection and re-seed the latent reservoir.